Health care organizations are rapidly adopting artificial intelligence (AI)-enabled tools, yet nurse leaders often lack a clear framework to evaluate, govern, and safely scale these technologies. This article presents a practical, system-level AI governance model grounded in risk mitigation, interdisciplinary partnership, and nursing leadership decision rights commonly enacted through nursing professional governance structures. We outline core components of an effective governance structure, including clinical usefulness, safety and reliability, fairness and inclusiveness, transparency and explainability, privacy and security, and organizational accountability. Real-world examples illustrate how nurse executives can guide responsible AI adoption to reduce cognitive load, improve documentation efficiency, and enhance patient outcomes. The framework equips nursing leaders with actionable strategies and practical workflow checklist to lead AI transformation in complex health care environments.
Background: Acute kidney injury (AKI) is a common complication following cardiac surgery and is associated with increased morbidity and mortality. Contemporary national estimates of its clinical and economic burden in the United States remain limited. Methods: We conducted a retrospective cross-sectional study using the Nationwide Inpatient Sample (NIS) for 2022–2023. Adult hospitalizations undergoing coronary artery bypass grafting (CABG), valve surgery, or combined CABG and valve surgery were identified using ICD-10-PCS codes. Hospitalizations with end-stage kidney disease were excluded. The primary exposure was AKI. Outcomes included in-hospital mortality, length of stay (LOS), non-home discharge, and hospitalization cost. Survey-weighted multivariable regression models were used to evaluate the independent association between AKI and study outcomes. Results: The final cohort included 133,801 hospitalizations, representing an estimated 669,005 cardiac surgery hospitalizations nationally. AKI occurred in 123,240 weighted hospitalizations (18.4%). Compared with hospitalizations without AKI, those with AKI had higher unadjusted mortality (7.21% vs. 0.71%), longer LOS (14.4 vs. 6.3 days), greater rates of non-home discharge (68.1% vs. 41.2%), and higher hospitalization costs ($97,452 vs. $56,253). After adjustment for demographic, socioeconomic, clinical, and procedural characteristics, AKI remained independently associated with in-hospital mortality (adjusted odds ratio [aOR] 9.91, 95% confidence interval [CI] 8.95–11.00), non-home discharge (aOR 2.52, 95% CI 2.42–2.63), prolonged LOS (adjusted rate ratio [aRR] 1.88, 95% CI 1.85–1.91), and increased hospitalization costs (cost ratio 1.59, 95% CI 1.56–1.61). AKI was associated with an adjusted incremental cost of $33,497 per hospitalization, corresponding to an estimated national attributable cost burden of $4.13 billion during the study period. Conclusions: AKI complicates nearly one in five cardiac surgery hospitalizations in the United States and is associated with substantially increased mortality, healthcare utilization, and hospitalization costs. These findings highlight the significant clinical and economic burden of cardiac surgery–associated AKI and support continued efforts to improve prevention, risk stratification, and perioperative management.
Occupational injuries remain an important source of morbidity and mortality in the United States. Recent changes in workforce participation, employment patterns, and workplace conditions may have altered the epidemiology of occupational trauma. This study evaluated national trends in work-related traumatic injuries from 2017 to 2023 using the National Trauma Data Bank. We performed a retrospective cross-sectional study using the American College of Surgeons National Trauma Data Bank Participant Use Files from 2017 to 2023. Work-related trauma encounters among patients aged 14 years or older were included. Temporal trends in demographic, injury, and clinical characteristics were assessed using Mann–Kendall trend testing. Multivariable regression models were used to evaluate factors associated with hospital length of stay (LOS) and mortality. From 2017 to 2023, work-related trauma demonstrated significant demographic shifts. The proportion of occupational injuries increased among patients aged 14–19 years and those aged 60 years or older, female patients, Hispanic patients, and patients with Medicare or self-pay status. Pre- versus post-COVID period was not independently associated with hospital LOS or mortality. Longer hospital LOS was associated with older age, higher occupational hazard category, transportation-related mechanisms, penetrating trauma, major injury severity, multiple injured body regions, comorbidity burden, and positive alcohol or drug testing. Mortality was associated with older age, Black race, Medicare or self-pay status, lower trauma center level designation, penetrating trauma, major injury severity, multiple injured body regions, lower Revised Trauma Score, and comorbidity burden. Occupational injuries treated at U.S. trauma centers changed meaningfully from 2017 to 2023, with increasing representation among younger workers, older workers, female patients, Hispanic patients, and patients without private insurance. These findings support targeted occupational injury prevention strategies and highlight the need for improved surveillance of vulnerable worker populations.
Purpose:The objective of this study was to describe the epidemiology, mechanisms of injury, and outcomes of vascular trauma patients admitted to an American College of Surgeons level I trauma center located in a predominantly suburban county on Long Island, New York, United States, and to compare these findings with the existing literature. Methods:This retrospective observational study used data collected from the hospital's trauma registry for all patients with documented vascular trauma between January 2015 and December 2023, identified through relevant ICD-9 and ICD-10 codes. Results:The trauma registry query identified 208 vascular trauma cases out of 12,617 total trauma cases (1.7%). The overall mortality rate was 19.7%, and the amputation rate was 2.4%. Patients were predominantly male, with a mean age of 40 years. Black and Hispanic patients were disproportionately affected. Most injuries were blunt, and these were associated with higher Injury Severity Scores (ISS), lower Glasgow Coma Scale (GCS) scores, and longer hospital length of stay (LOS). Multivariate analysis demonstrated a significant overall effect of mechanism of injury (blunt vs. penetrating) on ISS, GCS, and hospital LOS. Truncal injuries carried higher mortality than face/neck and extremity injuries. Conclusions:Although relatively uncommon, vascular trauma remains associated with significant morbidity and mortality, particularly in blunt mechanisms and truncal injuries. The findings highlight the importance of regional epidemiological surveillance and raise concerns about racial disparities. These results emphasize the need for targeted prevention efforts, improved resource allocation, and further research to address the social and clinical factors underlying poor outcomes in vascular trauma.
